
<form class="form-horizontal" role="form">
    
    <div class="page-header">
<h2><b>Kết quả tìm kiếm</b></h2>
</div>
    
<div class="canhan">
    <div style="color: #d9534f;"><h4><b><ins> Thông tin cá nhân</ins></b></h4></div>
    
   <div class="form-group">
       <div  style="float: left; margin-left: 50px;"><label for="H&T" >Họ và Tên(*) :</label></div>
          <div style="float: left; margin-left: 83px;" class="col-sm-7" >
              <input type="username" class="form-control" id="H&T" placeholder="Username"></div>
         </div>
 
    <div class="form-group  ">
        <div  style="float: left; margin-left: 50px;"><label for="gt">Giới tính(*) :</label></div>
        <div style="float: left; margin-left: 110px;">
            <label>
                <input type="radio" name="sex" value="male" id="gt">Name</label></div>
        <div style="float: left; margin-left: 150px;">
            <label>
                <input type="radio" name="sex" value="female">Nữ</label></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="ns">Năm sinh(*) :</label></div>
        <div class="Năm" style="float:left; margin-left: 107px;">
  <select id="ns" class="form-control">
    <option value="0">Năm</option>
    <option value="2005">2005</option>
    <option value="2004">2004</option>
    <option value="2003">2003</option>
    <option value="2002">2002</option>
    <option value="2001">2001</option>
    <option value="2000">2000</option>
    <option value="1999">1999</option>
    <option value="1998">1998</option>
    <option value="1997">1997</option>
    <option value="1996">1996</option>
    <option value="1995">1995</option>
    <option value="1994">1994</option>
    <option value="1993">1993</option>
    <option value="1992">1992</option>
    <option value="1991">1991</option>
    <option value="2005">1990</option>
    <option value="2004">1989</option>
    <option value="2003">1988</option>
    <option value="2002">1987</option>
    <option value="2001">1986</option>
    <option value="2000">1985</option>
    <option value="1999">1984</option>
    <option value="1998">1983</option>
    <option value="1997">1982</option>
    <option value="1996">1981</option>
    <option value="1995">1980</option>
    <option value="1994">1979</option>
    <option value="1993">1978</option>
    <option value="1992">1977</option>
    <option value="1991">1976</option>
    <option value="2004">1975</option>
    <option value="2003">1974</option>
    <option value="2002">1973</option>
    <option value="2001">1972</option>
    <option value="2000">1971</option>
    <option value="1999">1970</option>
    <option value="1998">1969</option>
    <option value="1997">1968</option>
    <option value="1996">1967</option>
    <option value="1995">1966</option>
    <option value="1994">1965</option>
    <option value="1993">1964</option>
    <option value="1992">1963</option>
    <option value="1991">1962</option>                                    
    <option value="1992">1961</option>
    <option value="1991">1960</option>  
  </select>
        </div>
        <div  style="float: left; margin-left: 35px;"><label for="qq">Quê quán(*) :</label></div>
     <div style="float: left; margin-left: 22px;">
         <select id="qq" class="form-control">
    <option value="0">Tỉnh/Thành</option>
    <option value="1">Hồ Chí Minh</option>
    <option value="2">Đà Nẵng</option>
    <option value="3">Huế</option>
    <option value="4">Thanh Hóa</option>
    <option value="5">Hải Phòng</option>
    <option value="6">Hà Nội</option>
    <option value="7">Cà Mau</option>
    <option value="8">Quảng Ngãi</option>
    <option value="9">Bình Định</option>
    <option value="10">Đà Lạt</option>
    <option value="11">Quảng Ninh</option>
    <option value="12">Đồng Tháp</option>
    <option value="13">Tiền Giang</option>
    <option value="14">Hậu Giang</option>
    <option value="15">Cần Thơ</option>
    <option value="16">Long An</option>
    <option value="17">Bến Tre</option>
         </select>
     </div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="dc">Địa chỉ(*) :</label></div>
          <div style="float: left; margin-left: 108px;" class="col-sm-7" >
              <input class="form-control" id="dc" placeholder="Address" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="email">Email(*) :</label></div>
          <div style="float: left; margin-left: 119px;" class="col-sm-7">
              <input class="form-control" id="email" placeholder="Email" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="sdt">Số Điện Thoại(*) :</label></div>
          <div style="float: left; margin-left: 60px;" class="col-sm-7">
              <input class="form-control" id="sdt" placeholder="09xxxxxxxx" /></div>
         </div>
</div>
<div class="hocvan">
    <div style="color: #d9534f;"><h4><ins> <b>Thông tin học vấn</b></ins></h4></div>
        <div class="form-group">
            <div  style="float: left; margin-left: 50px;"><label for="hv">Học vấn(*) :</label></div>
        <div  style="float:left; margin-left: 115px;">
  <select class="form-control" id="hv">
        <option value="0">Trình độ</option>
        <option value="1">Trung cấp</option>
        <option value="2">Đại học</option>
        <option value="3">Cao đẳng</option>
         <option value="3">Thạc sỹ</option>
         </select>
            </div>  
        </div>
        <div class="form-group">
            <div  style="float: left; margin-left: 50px;"><label for="th" >Trường học(*) :</label></div>
          <div style="float: left; margin-left:74px;" class="col-sm-7">
              <input class="form-control" id="th" placeholder="" /></div>
         </div>
        <div class="form-group">
            <div  style="float: left; margin-left: 50px;"><label for="cn" >Chuyên ngành(*) :</label></div>
          <div style="float: left; margin-left: 56px;" class="col-sm-7">
              <input class="form-control" id="cn" placeholder="" /></div>
         </div>
      <div class="form-group">
          <div  style="float: left; margin-left: 50px;"><label for="bl">Bạn là(*) :</label></div>
        <div style="float: left; margin-left: 126px;">
            <label><input type="radio" name="sex" value="male" id="bl">Học sinh</label></div>
        <div style="float: left; margin-left: 56px;">
            <label> <input type="radio" name="sex" value="female">Sinh viên</label></div>
        <div style="float: left; margin-left: 56px;">
            <label><input type="radio" name="sex" value="female">Đi làm</label></div>
       </div>
</div>
<div class="dayhoc">
    <div style="color: #d9534f;"><h4><ins><b> Thông tin lớp muốn dạy</b></ins></h4></div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="lmn" >Lớp muốn nhận(*) :</label></div>
          <div style="float: left; margin-left: 47px;" class="col-sm-7">
              <input class="form-control" id="lmn" placeholder="DH or THPT" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="md">Môn dạy(*) :</label></div>
          <div style="float: left; margin-left: 96px;"class="col-sm-7">
              <input class="form-control" id="md" placeholder="Toán-Lý-Hóa-Sử........" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="dd">Địa điểm(*) :</label></div>
          <div style="float: left; margin-left: 95px;" class="col-sm-7">
              <input class="form-control" id="dd" placeholder="" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="sb">Số buổi(*) :</label></div>
          <div style="float: left; margin-left: 102px;" class="col-sm-2">
              <input class="form-control" id="sb" placeholder="1->4/buổi" /></div>
        <div  style="float: left; margin-left: 50px;"><label for="tg">Thời gian(*) :</label></div>
          <div style="float: left; margin-left: 12px;"  class="col-sm-2">
             <input class="form-control" id="tg" placeholder="tùy chọn" /></div>
         </div>
    <div class="form-group">
        <div  style="float: left; margin-left: 50px;"><label for="nd">Ngày dạy(*) :</label></div>
          <div style="float: left; margin-left: 93px;" class="col-sm-2">
              <input class="form-control" id="nd" placeholder="1->4/buổi" /></div>
        <div  style="float: left; margin-left: 50px;"><label for="l">Lương(*) :</label></div>
          <div style="float: left; margin-left: 30px;" class="col-sm-2">
              <input class="form-control" id="l" placeholder="1->4/buổi" /></div>
         </div>
</div>
<div class="dongy">
    <input type="checkbox" name="vehicle" value="Bike"><a href="url"><ins> Tôi đồng ý các điều khoản</ins></a>
</div>
    <div class="button">
        <div  style="float: left; margin-left:228px; background-color: #5bc0de;"">
            <button type="button" name="dangky" class="btn btn-info">
                <span class="glyphicon glyphicon-thumbs-up"> <b>Đăng Ký</b></span></button>   
        </div>
        <div  style="float: left; margin-left:76px; background-color: #5bc0de;">
            <button type="button" name="dangky" class="btn btn-info">
                <span class="glyphicon glyphicon-thumbs-down"> <b>Làm Lại</b></span></button>   
        </div>
    </div>
</form>
</div>